腹腔鏡下胃局所切除の適応について:特にリンパ節転移に関して

概要

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We investigated the indications for laparoscopic surgery in 351 early gastric cancers and 15 leiomyosarcoma according to the relationship between lymph node metastasis and other clinicopathological factors (depth of invasion, location, gross findings, histologic type, maximum tumor size, or value of CEA). The incidence of lymph node metastasis in cases of mucosal cancer (m ca. ) and submucosal cancer (sm ca. ) were 4.9% and 18.0%, respectively. The rate of lymph node metastasis of sm ca. was slightly higher than that of m ca. for each clinicopathological factor. Lymph node metastasis in depressed type of m ca. was found more than 15mm in diameter or UI (+). No lymph lode metastasis was noted in elevated type and flat type of m ca. But the incidence of lymph node metastasis of m ca. was significantly higher in more than 30mm. Furthermore, lymph node metastasis of leiomyosarcama was found in 45mm and 98mm lesion. The candidate for laparoscopic surgery was considered less than 15mm in diamaeter and UI(-) in depressed type or less than 30mm in diameter in elevated type of m ca. and less than 40mm in diameter of leimyosarcoma.
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